Bread of Life Data Verification Form

Bread of Life Data Verification

The directors of the Bread of Life Walk To Emmaus want to verify the information contained in our database that is used to produce the Emmaus directory, the mail lists for the newsletter and other lists of team and volunteers or other uses authorized by the board. We presently have over 1600 listings. It is believed that many of these are inaccurate or incomplete. Furthermore, we need to reduce the newsletter mailing to only those that are reading, making use of the newsletter and who are not in other Emmaus communities. To accomplish these goals we need your help. Below are questions that cover what we need.
This information is only for the benefit of our Emmaus community and will not be used for business purposes.

First Name (s):	Last Name:
Address:
City:	State: Zip (Nine digit):
Phone No. with Area code	Emmaus community:
Men's Walk No.	Women's Walk No. Chrysalis Flight No.
E-mail address:	E-mail address No.2
	Would you like to receive the Crumbs by mail? Yes No
	Would you like to receive the Crumbs by e-mail? Yes No
	Are you a member of the Clergy? Yes No
	Omit my name from the Bread of Life Directory? Yes No
	Remove my name from all lists? Yes No
Comments: